Practical pathology

The chief sources of pathologic material are the autopsy, surgical operation, diagnostic excision and curetting, the spontaneous discharge of diseased tissue, and the experiment...

1. =AUTOPSY= (=Postmortem examination=, =necropsy=, =necroscopy=, =obduction=, =mortopsy=, =section=; Latin, =sectio cadaveris=, =sectio anatomica=, =autopsia cadaverica=, =sect...

=ORDER OF THE AUTOPSY.= In so complicated a piece of work as the complete autopsy it is absolutely necessary that a definite order of procedure be followed at every autopsy, alt...

=THE PROTOCOL.= Autopsy findings should be recorded in the form of complete, concise notes, following the order of the autopsy. Such a protocol should consist of _descriptive_ s...

=THE BEGINNING OF THE AUTOPSY.= The autopsy begins with the examination of the exterior of the body. The cadaver should be completely stripped of clothing and examined as a whol...

1. =METHODS OF EXAMINATION.= The spinal cord may be opened anteriorly or posteriorly. The choice of method is largely a matter of convenience or of individual skill in using cer...

1. =Removal of Skull-Cap.= For the section of the head the cadaver is placed upon its back with its head near the end of the table. The head may be elevated by a block placed be...

1. =The Main Incision.= After the examination of the cranium has been completed, the skull-cap is replaced and the anterior flap of the scalp drawn up over it, to hold it in pla...

1. =Thoracic Cavity.= As soon as the sternum is removed the =anterior mediastinum= and the =pleural cavities= are examined, noting first the =position= and =relation= of the =th...

1. =Removal of the Neck-Organs.= The block is left beneath the neck, and the chin pulled upward by an assistant, so as to put the skin of the neck on a tight stretch. If the mai...

The preliminary general inspection of the peritoneal cavity was made after the main incision. (See Chapter VII.) After the examination of the neck and thoracic organs has been c...

1. =Male Pelvis.= When the removal of the external genitals is permitted the fundus of the bladder is taken in the left hand and pulled toward the head of the cadaver while the...

1. =Bones and Bone-Marrow.= The methods employed will depend wholly upon the indications in any given case, the anatomic relations and the aim of the examination. Anatomic knowl...

_b. Skull._ The cranium is opened, after the removal of the scalp, in the usual way, by cutting with the scissors into the posterior angle of the anterior fontanel and then intr...

As has been stated above, every autopsy should be conducted as if it were a medicolegal case, and autopsy-protocols should be so complete and accurate that they may be accepted...

When the autopsy is finished the body-cavities are cleansed and then thoroughly dried. No blood, stomach- or intestinal-contents should be left in the cadaver. All bleeding or d...

1. =Autopsies on Animals.= In the case of the small animals used ordinarily for laboratory purposes, such as the mouse, rat, guinea-pig, rabbit, cat and dog, the animal is put u...

=INTRODUCTION.= The material obtained by autopsy, surgical operation, curettage, excision, spontaneous discharge, animal experimentation, etc., may be examined microscopically i...

For practical diagnostic work or for pathologic research various instruments and utensils are necessary, although the expense of fitting up a working pathologic laboratory is no...

Pathologic material is examined in the fresh state when it is desired to make a diagnosis in the shortest time possible, or when the processes of fixation and hardening produce...

For preserving gross objects for museum specimens alcohol or formol may be employed. The former bleaches the tissues so that ultimately they are almost destitute of color. Formo...

=GENERAL CONSIDERATIONS.= For the examination of material that may be injured by freezing, or when very thin sections are required for complicated staining procedures, it become...

Bone and tissue containing deposits of lime must be decalcified before they can be sectioned on the microtome. The decalcification should be carried out after fixation and befor...

The most perfect methods of fixation and hardening do not permit the cutting of fine sections on a microtome without the freezing of the tissue, or its =infiltration= and =imbed...

Fixed and hardened tissues may be sectioned on a microtome without freezing or imbedding, or they may be cut on a freezing-microtome; or, having been imbedded in either celloidi...

Sections of fresh material, unimbedded or imbedded tissues must be treated by a series of processes before they are finally permanently mounted and ready for use. These processe...

=THEORIES OF STAINING.= The exact nature of the process of staining has not yet been determined. Various theories have been advanced, explaining the affinity of the tissues for...

=I. AMYLOID.= The best selective staining of amyloid is obtained with relatively fresh tissues; long preservation in alcohol or formol tends to weaken the reactions. Probably th...

Rapid fixation and hardening are requisites for the successful staining of micro-organisms in sections. Alcohol, Zenker’s, mercuric chloride and formol give best results; Müller...

_A. FILMS._ The blood may be obtained from the pulp of the ring finger, from the skin over the knuckles, or from the posterior aspect of the lobe of the ear. The place selected...

has been carried out place sections in an alkaline solution before staining, and stain for a longer period than usual. Methylene-blue and eosin stain osteoblasts and osteoclasts...

1. =BLOOD.= Fresh spots should be scraped off and examined in physiologic salt solution. Older spots are scraped off when possible, or if the spots are on clothing or other fabr...

1. =Preparation.= Analyze the method of preparation of the specimen, noting-methods of fixation, hardening, imbedding, injection, impregnation, staining, etc. Note the reaction...